Night Guards (Bruxing)

Bruxing is when a person clenches and grinds their teeth.  It has been estimated that over 30% of all adults grind their teeth at night while they sleep.  This subconscious action is a way of dealing with daily stress and anxiety.  As a patient wears down their enamel, the teeth become flat, allowing them to grind more easily.  A person who grinds at night may awake with discomfort in the muscles of the jaw and face, but left unguarded, bruxing can cause a variety of problems including cracked or broken teeth, abfractions, gum recession, sensitivity to temperatures, headaches, and Temporal-Mandibular Joint (TMJ) pain.

Night Guards do not stop night time grinding, rather they are designed to act as a buffer between the upper and lower teeth.  The Dentist or his Assistant will take impressions of the patient's upper and lower arches.  A bite impression is also required.  These impressions are poured in stone and used to fabricate the guard by either a Dental Lab Technician or in the Dental Office.  Guards which are custom made fit better and last longer than those which are bought over-the-counter.  At delivery, the Dentist will make sure that the guard fits properly and the occlusion (bite) is balanced.  A muscle relaxer may be prescribed for use at night during the first week of wear.

Soft Night Guards

Soft Night Guards are made of a thick poly-vinyl material which is heated and vacu-pressed onto the patient's cast.  Soft Night Guards are good for light bruxers and those who clench their teeth. 

Hard Night Guards

Hard Night Guards are made of a thick acrylic tightly molded to the patient's cast.  Hard Guards are recommended for heavy bruxers and patients who experience multiple symptoms of night time grinding.  Hard Guards can be modified to include Ball Clasps to help retention and / or a Soft Liner for additional enamel protection.

 

Sleep Apnea Appliances

Sleep Apnea is a sleeping disorder in which the patient stops breathing multiple times during the night, often waking themselves by snorting and gasping for air.  Sleep Apnea patients may have from 10 to 100 or more episodes per night due to a constricted air way.  This leaves the patient tired and drained, often falling asleep during the day while doing mundane tasks such as watching television and driving.  Years of disrupted sleep has been proven to reduce a person's life expectancy.

Patients who believe they have Sleep Apnea should consult a Doctor who specializes in Sleep Disorders.  A Sleep Study should be done to determine what level of Apnea occurs.  The first line of treatment for Sleep Apnea is a C-PAP machine.  This is a sleep mask which applies forced air into the patient while they sleep, preventing the airway from collapsing.  Although successful in most cases, many patients are unable to adapt to wearing the device while they sleep.

For those who cannot adjust, an intra-oral appliance is recommended.  Several appliances have been developed, but all are based on the same concept --- to increase the airway space by opening the mouth and bringing the jaw forward into an extended, but comfortable, position.  At our office, Dr. Freeman himself suffers from Sleep Apnea, and due to his personal connection, keeps up with the latest developments concerning this field.  Although, many appliances are available, the following have been Sleep Study Tested and have had the most success.

Elastic Mandibular Advancement (EMA)

This is the original appliance designed to help patients with Sleep Apnea.  It is still being manufactured today because it works.  Created by specially trained Laboratory Technicians, the EMA consists of individual upper and lower hard acrylic trays which are held together by Elastic Straps.  The length of the strap depends on the patient's impressions and how far they are able to extend  their jaw forward.  When in the mouth, the Elastic Straps advance the jaw to open the air way, but allow the patient the flexibility of side-to-side movement.  Like any rubber band, the straps eventually lose their elasticity, and when the apnea returns, new straps can be placed on by the patient.

Tap III

The TAP appliance has made several improvements over the years, taking the advice of Doctors and Patients when trying to improve their product.  The TAP III consists of an upper and lower appliance.  Once in place, a screw device in the front of the mouth engages a ball and socket mechanism.  When advanced, the jaw is brought forward opening the airway.  The patient is allowed minimal jaw movement.

SomnoDent

SomnoDent is one of the newest Sleep Apnea devices on the market.  Combining the positive features of other appliances, SomnoDent brings the jaw forward using advancement screws on both the left and right side.  By advancing the screws on the upper unit, a part of the appliance is pushed forward.  This "block" engages with the "fin" on the lower unit to hold the jaw in an advanced position.  SomnoDent can be modified by adding a soft liner to protect the teeth and small ball clasps to utilize rubber bands if needed.  It is the most form fitting of the appliances, polished to a silky shine, and requires very little adjustment.

For more information on SomnoDent, click here download their brochure

Snore Guards

Snore Guards, in many ways, are much like Sleep Apnea guards.  The majority of the appliances bring the jaw forward to an end-to-end position which helps to open the airway.  Some of the most popular Snore Guards are fabricated as one piece with an opening in the front for passive air flow.  The largest difference between a Sleep Apnea appliance and a Snore Guard is that Snore Guards aid in reducing snoring but do not significantly reduce Apnea episodes when tested in sleep studies.

 

Sports Guards

Are you or your child into contact sports?  23% of all sport injuries include injuries of the mouth and teeth.  Protect your smile by wearing a Sports Guard.  Guards can prevent broken teeth as well as injuries to the lips, tongue, and jaw.  When properly fitted, it should stay in place during sporting events and allow the athlete to breathe easily.  Universal mouth guards can be purchased at the Sporting Goods Store.  Some are made to wear right out of the box, while others need to be heated in water and molded to the athlete's bite.  At the office of Dr. Mark Freeman & Associates, we create custom fitted Sports Guards for all types of sports.  An impression is taken of the upper arch and a stone model is poured.  A Poly-Vinyl sheet is heated and Vacu-Pressed onto the cast.  Our Assistants trim and polish the guards.  Custom made guards are less bulky in the mouth and hold better to the athlete's dentition.  Mouth guards should be worn during practice as well as during competitions and games.

The American Dental Association recommends that mouth guards be worn during heavy contact sports. For more information please visit their website:

http://www.ada.org/2970.aspx 


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